Histological evolution of hepatitis <scp>C</scp> virus infection after renal transplantation

Uehara, Silvia Naomi de Oliveira; Emori, Christini Takemi; Pereira, Patrícia da Silva Fucuta; Perez, Renata M.; Pestana, José Osmar Medina; Lanzoni, Valéria Pereira; Silva, Ivonete Sandra Souza e; Silva, Antônio Eduardo Benedito; Ferraz, M.L.G.

doi:10.1111/j.1399-0012.2012.01635.x

Cited by 16 publications

(8 citation statements)

References 25 publications

(41 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although some studies [1,4 && ,5 && ] demonstrated that HCV infection does not negatively influence liver histology in the long term, 50% of kidney transplant patients showed a slow progression of fibrosis, whereas others showed a fast progression of fibrosis. De Oliveira et al [16] studied 22 HCV-positive patients with biopsies before and after ransplantation. Fibrosis progression after transplantation was observed in 50% and worsening necroinflammatory activity was observed in 32% of the patients.…”

Section: Epidemiology Prevalence and Diagnostic Tests Of Hepatitis Cmentioning

confidence: 99%

“…De Oliveira et al [16] studied 22 HCV-positive patients with biopsies before and after ransplantation. The progression occurred even among those without significant histological lesions in pretransplant biopsy [16]. The progression occurred even among those without significant histological lesions in pretransplant biopsy [16].…”

Section: Epidemiology Prevalence and Diagnostic Tests Of Hepatitis Cmentioning

confidence: 99%

See 1 more Smart Citation

Hepatitis C and renal transplantation

Morales¹,

Aguado

2012

Current Opinion in Organ Transplantation

View full text Add to dashboard Cite

show abstract

Section: Epidemiology Prevalence and Diagnostic Tests Of Hepatitis Cmentioning

confidence: 99%

Section: Epidemiology Prevalence and Diagnostic Tests Of Hepatitis Cmentioning

confidence: 99%

Hepatitis C and renal transplantation

Morales¹,

Aguado

2012

Current Opinion in Organ Transplantation

View full text Add to dashboard Cite

show abstract

“…Within the kidney transplant population, as well as patients who are receiving hemodialysis, the prevalence of HCV infection is approximately 5%‐9% . In kidney transplant patients, HCV infection is associated with increased liver‐related mortality and fibrosis progression, and up to 28% of kidney transplant recipients will die of chronic liver disease . HCV infections in kidney transplant recipients are also associated with increased rates of glomerulopathies and risk of cardiovascular death …”

mentioning

confidence: 99%

Glecaprevir/Pibrentasvir Treatment in Liver or Kidney Transplant Patients With Hepatitis C Virus Infection

et al. 2018

View full text Add to dashboard Cite

Well‐tolerated, ribavirin‐free, pangenotypic hepatitis C virus (HCV) treatments for transplant recipients remain a high priority. Once‐daily glecaprevir/pibrentasvir demonstrates high rates of sustained virologic response at 12 weeks posttreatment (SVR12) across all major HCV genotypes (GTs). This trial evaluated the safety and efficacy of glecaprevir/pibrentasvir for patients with chronic HCV GT1‐6 infection who had received a liver or kidney transplant. MAGELLAN‐2 was a phase 3, open‐label trial conducted in patients who were ≥3 months posttransplant. Patients without cirrhosis who were HCV treatment‐naive (GT1‐6) or treatment‐experienced (GT1, 2, 4‐6; with interferon‐based therapy with or without sofosbuvir, or sofosbuvir plus ribavirin) received glecaprevir/pibrentasvir (300/120 mg) once daily for 12 weeks. The primary endpoint compared the percentage of patients receiving glecaprevir/pibrentasvir with SVR12 to a historic SVR12 rate based on the standard of care. Safety of glecaprevir/pibrentasvir was assessed. In total, 80 liver transplant and 20 kidney transplant patients participated in the trial. Most patients had no or minimal fibrosis (80% had fibrosis scores F0‐F1) and were infected with HCV GT1 (57%) or GT3 (24%). The overall SVR12 was 98% (n/N = 98/100; 95% confidence interval, 95.3%–100%), which exceeded the prespecified historic standard‐of‐care SVR12 threshold of 94%. One patient experienced virologic failure. One patient discontinued because of an adverse event considered to be unrelated to treatment; this patient achieved SVR12. Adverse events were mostly mild in severity, and laboratory abnormalities were infrequent. Conclusion: Once‐daily glecaprevir/pibrentasvir for 12 weeks is a well‐tolerated and efficacious, ribavirin‐free treatment for patients with chronic HCV GT1‐6 infection who have received a liver or kidney transplant. (http://ClinicalTrials.gov NCT02692703.) (Hepatology 2018; 00:000‐000).

show abstract

“…The correlation between transferase concentration, viral load, and severity of histological lesion is not well established in HCV-positive immunocompetent individuals and renal transplant recipients. 23 Some studies suggest that the use of mTORi may be associated with a less aggressive evolution of the HCV infection, but the level of evidence is low. 24 Studies on liver transplantation reported a beneficial effect of mTOR inhibitors on viral load in HCV patients after liver transplantation in comparison to CNI-based regimens.…”

Section: Discussionmentioning

confidence: 99%

Effect of conversion from calcineurin inhibitors to everolimus on hepatitis C viremia in adult kidney transplant recipients

et al. 2018

View full text Add to dashboard Cite

Efeitos da conversão de inibidores da calcineurina para everolimo na viremia por hepatite C em receptores adultos de transplantes renais Introdução: Atualmente não há um protocolo imunossupressor específico para os receptores de transplantes renais portadores de hepatite C (HCV). Assim, o objetivo deste estudo foi avaliar o efeito da conversão a Everolimo (EVR) na HCV em receptores adultos de transplantes renais. Método: Trata-se de um estudo unicêntrico, prospectivo, randomizado, exploratório, controlado, aberto em receptores de aloenxertos renais com sorologia positiva para HCV. Os participantes foram randomizados para conversão a EVR ou manutenção dos inibidores da calcineurina. Resultados: Trinta pacientes foram randomizados e 28 foram acompanhados por um período de 12 meses (grupo de conversão, Grupo 1 = 15 e grupo controle, Grupo 2 = 13). Níveis de RT-PCR HCV descritos em valores logarítmicos foram compará-veis entre os grupos e entre pacientes em um mesmo grupo. A análise estatística não mostrou efeitos de interação entre tempo e grupo (valor p G*M = 0,852), ao longo do tempo em cada grupo (valor p M = 0,889) e entre grupos (valor p G = 0,286). O Grupo 1 apresentou uma maior incidência de eventos de dislipidemia (p = 0,03) e proteinúria (p = 0,01); não houve diferença na incidência de anemia (p = 0,17), diabetes mellitus de início pós-transplante (p = 1,00) ou infecção do trato urinário (p = 0,60). A TFGe média foi semelhante nos dois grupos. Conclusão: Nosso estudo não mostrou redução da carga viral após conversão a EVR com manutenção do tratamento antiproliferativo. ResumoPalavras-chave: Imunossupressão; Hepatite C; Transplante Renal; Carga Viral. Introduction:Currently, there is no specific immunosuppressive protocol for hepatitis C (HCV)-positive renal transplants recipients. Thus, the aim of this study was to evaluate the conversion effect to everolimus (EVR) on HCV in adult kidney recipients. Method: This is an exploratory single-center, prospective, randomized, open label controlled trial with renal allograft recipients with HCV-positive serology. Participants were randomized for conversion to EVR or maintenance of calcineurin inhibitors. Results: Thirty patients were randomized and 28 were followed-up for 12 months (conversion group, Group 1 = 15 and control group, Group 2 = 13). RT-PCR HCV levels reported in log values were comparable in both groups and among patients in the same group. The statistical analysis showed no interaction effect between time and group (p value G*M = 0.852), overtime intra-groups (p-value M =0.889) and between group (p-value G = 0.286). Group 1 showed a higher incidence of dyslipidemia (p = 0.03) and proteinuria events (p = 0.01), while no difference was observed in the incidence of anemia (p = 0.17), new onset of post-transplant diabetes mellitus (p = 1.00) or urinary tract infection (p = 0.60). The mean eGFR was similar in both groups. Conclusion: Our study did not show viral load decrease after conversion to EVR with maintenance of antiproliferative therapy. AbstRAct

show abstract

Histological evolution of hepatitis C virus infection after renal transplantation

Cited by 16 publications

References 25 publications

Hepatitis C and renal transplantation

Hepatitis C and renal transplantation

Glecaprevir/Pibrentasvir Treatment in Liver or Kidney Transplant Patients With Hepatitis C Virus Infection

Effect of conversion from calcineurin inhibitors to everolimus on hepatitis C viremia in adult kidney transplant recipients

Contact Info

Product

Resources

About